头孢哌酮钠舒巴坦钠致癫痫发作  

Epileptic seizures induced by cefoperazone sodium and sulbactam sodium

作　　者：肖昌钱[1] 韩奇[1] 

机构地区：[1]浙江医院药剂科,杭州310013

出　　处：《药物不良反应杂志》2015年第1期55-56,共2页Adverse Drug Reactions Journal

摘　　要：1例79岁男性患者因慢性阻塞性肺疾病急性加重,予头孢哌酮钠舒巴坦钠1.5g,2次/d静脉滴注;左氧氟沙星0.5g,1次/d静脉滴注;氨溴索45 mg,2次/d静脉注射;多索茶碱0.2g,2次/d静脉泵入.第7天停用左氧氟沙星,第13天停用氨溴索和多索茶碱.第16天头孢哌酮钠舒巴坦钠输注完毕后,患者突发意识丧失,四肢抽搐,牙关紧闭,双眼向右侧凝视.立即静脉注射甲泼尼龙40 mg,约1 min后患者意识转清,症状缓解.随后予丙戊酸钠400 mg静脉注射,同时相同剂量丙戊酸钠30 mg/h静脉泵入.第17天头孢哌酮钠舒巴坦钠静脉滴注结束后约2h,患者再次出现上述症状.立即静脉注射地西泮5 mg,将丙戊酸钠调为80 mg/h静脉泵入,约2 min后症状缓解.停用头孢哌酮钠舒巴坦钠,并予丙戊酸钠静脉注射（400 mg,1次/d）和口服（0.5g,2次/d）.此后患者未再出现癫痫发作.A 79-year-old man received an intravenous （Ⅳ） infusion of cefoperazone sodium and sulbactam sodium 1.5 g every 12 hours with concomitant use of levofloxacin 0.5 g once daily,doxofylline injection 0.2 g via pump twice daily,and an Ⅳ push of 45 mg ambroxol injection twice daily for acute exacerbation of chronic obstructive pulmonary disease.Levofloxacin was discontinued after 7 days of treatments ambroxol and doxofylline were discontinued after 13 days of treatments.Just after completion of the infusion of cefoperazone sodium and sulbactam sodium on day 16 of treatment,the patient suddenly experienced unconsciousness,convulsion of extremities,gnathospasmus,and eyes gazing rightwards,which lasted about one minute.An Ⅳ injection of methylprednisolone sodium succinate 40 mg was given immediately and 1 minute later,his consciousness restored and symptoms relieved.And then an Ⅳ injection of sodium valproate 400 mg and sodium valproate 30 mg/h via a pump were given.On day 17,2 hours after completion of the infusion of cefoperazone sodium and sulbactam sodium,the symptoms mentioned above appeared again.An Ⅳ push of diazepam 5 mg and sodium valproate 80 mg/h were given and 2 minutes later,the symptoms alleviated gradually.Subsequently,cefoperazone sodium and sulbactam sodium was discontinued,an Ⅳ push of sodium valproate 400 mg once daily and an oral sodium valproate 0.5 g twice daily were given.After that,he didn＆#’t experience epilepsy seizure again.

关 键 词：头孢哌酮 癫痫 肾功能不全 

分 类 号：R742.1[医药卫生—神经病学与精神病学]